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在下肢静脉性溃疡治疗中比较泡沫复合材料与水凝胶泡沫敷料:一项对照临床研究。

Comparing a foam composite to a hydrocellular foam dressing in the management of venous leg ulcers: a controlled clinical study.

作者信息

Vanscheidt Wolfgang, Sibbald R Gary, Eager Catherine A

机构信息

University of Freiburg, Germany.

出版信息

Ostomy Wound Manage. 2004 Nov;50(11):42-55.

Abstract

Venous leg ulcers are the most prevalent form of chronic wounds in the Western world. The principles of moist wound healing coupled with the use of graduated compression bandaging have become the cornerstone of treatment for venous leg ulcers but not all moist dressings are alike. To compare the attributes of a foam composite dressing with those of a hydrocellular foam dressing in the management of venous leg ulcers, a prospective, randomized, comparative 12-week study was conducted in 15 centers in the US, Canada, France, Germany, and the UK. Dressings were changed and compression bandages applied per manufacturer recommendations and dressing performance was assessed at every dressing change and at the final evaluation. Patients with venous ulcers were randomized to treatment for 12 weeks with either hydrocellular foam (n = 52) or foam composite (n = 55) dressing. Healing differences between the groups were not statistically significant, with 36% of patients using foam composite dressing healed in a mean of 66 days and 39% of patients using hydrocellular foam dressing healed in a mean of 73 days. However, the foam composite dressing performed significantly better than the hydrocellular foam dressing with regard to condition of the periwound skin - 55% of patients in the foam composite group having healed or markedly improved surrounding skin compared to 37% of patients using hydrocellular foam (P = 0.03). The foam composite dressing was rated significantly better than the hydrocellular foam dressing ("very good" to "excellent") in level of satisfaction with conformability (87% and 75%, respectively, P = 0.05); being non-sensitizing (73% and 52%, respectively, P = 0.02); and ease of application (93% and 81%, respectively, P = 0.01). The findings reported in this study suggest that the foam composite dressing offers significant improvements in the quality of life of patients with venous leg ulcers as well as for their caregivers.

摘要

下肢静脉溃疡是西方世界最常见的慢性伤口形式。湿性伤口愈合原则加上使用分级加压绷带已成为下肢静脉溃疡治疗的基石,但并非所有湿性敷料都一样。为了比较泡沫复合敷料和水凝胶泡沫敷料在治疗下肢静脉溃疡方面的特性,在美国、加拿大、法国、德国和英国的15个中心进行了一项为期12周的前瞻性、随机、对照研究。按照制造商的建议更换敷料并应用加压绷带,每次更换敷料时以及在最终评估时评估敷料性能。患有静脉溃疡的患者被随机分为两组,分别使用水凝胶泡沫敷料(n = 52)或泡沫复合敷料(n = 55)进行为期12周的治疗。两组之间的愈合差异无统计学意义,使用泡沫复合敷料的患者中有36%在平均66天内愈合,使用水凝胶泡沫敷料的患者中有39%在平均73天内愈合。然而,在伤口周围皮肤状况方面,泡沫复合敷料的表现明显优于水凝胶泡沫敷料——泡沫复合组中有55%的患者伤口周围皮肤愈合或明显改善,而使用水凝胶泡沫敷料的患者这一比例为37%(P = 0.03)。在对贴合性的满意度方面(分别为87%和75%,P = 0.05);在无致敏性方面(分别为73%和52%,P = 0.02);以及在使用便捷性方面(分别为93%和81%,P = 0.01),泡沫复合敷料的评分明显高于水凝胶泡沫敷料(“非常好”至“优秀”)。本研究报告的结果表明,泡沫复合敷料能显著改善下肢静脉溃疡患者及其护理人员的生活质量。

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